SME-Ins Claims

Job Summary

This hybrid subject matter expert role in insurance claims is responsible for providing accurate and timely support for customer service and domain-driven activities within a multinational organization. The selected professional will review claims, coach stakeholders on process details, and maintain consistent compliance with established standards while working rotating shifts with no travel. This role directly supports stronger customer confidence and operational excellence across the company’s insurance services portfolio.

Responsibilities

Review incoming insurance claims and related customer service requests to confirm coverage, identify documentation gaps, and ensure each case is handled accurately in accordance with internal guidelines and domain standards.

Manage customer service communications across multiple channels by delivering clear explanations of claim status, required next steps, and resolution timelines while using a calm, empathetic approach.

Partner with internal operations teams to improve claim intake and assessment processes, and drive faster turnaround times and lower rework by completing thorough case reviews.

Complete end-to-end documentation audits for claim files to verify that information is complete, consistent, and compliant with process requirements, minimizing downstream processing problems.

Investigate claim details using available systems and tools to identify potential inconsistencies and escalate complex or unclear situations through the appropriate escalation pathways.

Deliver organized insights and feedback on repeated customer service concerns and claim processing challenges, enabling product and process owners to refine procedures and service scripts.

Back continuous improvement efforts by monitoring key performance metrics related to claim resolution accuracy, customer satisfaction scores, and cycle time, and by recommending practical enhancements.

Work with training and quality teams by providing real-world case examples and daily operational insights to support stronger learning materials and quality checklists.

Contribute to knowledge base improvements by drafting clear process updates and frequently asked questions that help colleagues resolve claims and customer inquiries more efficiently.

Thrive in a rotational shift setting by planning workload effectively and maintaining consistent responsiveness and quality regardless of shift timing.

Use hybrid work arrangements effectively by ensuring secure and confidential handling of sensitive claim information both on site and remotely, consistent with company policies.

Support the company’s purpose by helping customers manage stressful claim situations with clarity and fairness, strengthening trust in the organization and its insurance service offerings.

Participate in cross-functional discussions to represent claims and customer service perspectives, ensuring operational changes positively affect end customers and broader society through dependable risk protection.

Qualifications

Demonstrate substantial experience in insurance claims domain activities, with two to four years of hands-on involvement in processing or supporting claims operations in a professional environment.

Exhibit strong customer service capabilities, including active listening, accurate communication, and effective issue resolution that support high satisfaction and reduce repeat contacts.

Use working knowledge of property and casualty insurance fundamentals, including policy coverage limits, deductibles, exclusions, and the claim life cycle, to interpret case information effectively.

Show competence with standard office productivity tools and claims-related applications to log cases, update records, and produce straightforward reports for stakeholders.

Demonstrate adaptability to hybrid work and rotational shifts by efficiently organizing tasks, managing time constraints, and sustaining consistent performance levels.

Apply analytical judgment and strong attention to detail when reviewing claim information and customer data to support accurate decisions and fair outcomes for all parties.

Maintain a willingness to learn new processes, regulatory updates, and insurance-domain system enhancements, and apply those learnings to improve daily execution.

Certifications Required

Preferred certifications include insurance claims or customer service credentials such as INS or AIC or equivalent industry-specific training.